Recognizing the early signs of dementia

People who lose their keys or forget names often dismiss these temporary memory lapses as having a “senior’s moment.” However, persistent memory loss can be a sign of a more serious cognitive issue known as dementia.

Dementia—which the World Health Organization describes as a deterioration in memory, thinking, behaviour and the ability to perform everyday activities—is a major growing cause of disability and dependency among older people worldwide. Alzheimer’s disease, vascular disease and other types of disease all contribute to dementia.

The disease can lead to a loss of awareness, basic math skills, judgement and planning, according to the Public Health Agency of Canada. In its dementia strategy, objectives include supporting prevention and finding advanced therapies and a cure for dementia. There’s also a focus on improving the quality of life for the more than 500,000 Canadians who suffer from the disease, and their caregivers.

Is it dementia or normal aging?

It can be hard to spot the early signs of dementia versus what can sometimes be normal age-related memory loss, says Dr. Samir Sinha, director of health policy research at the National Institute on Ageing (NIA) at Toronto Metropolitan University in Toronto.

“There are a lot of misconceptions around what dementia is and isn’t, ” says Dr. Sinha who is also the director of Geriatrics at Sinai Health and the University Health Network in Toronto.

People need to determine if their forgetfulness or thinking problems are due to dementia or other illnesses, such as anxiety or depression, or side effects of certain medications, he explains. Some people who experience hearing loss may also be mistaken as being forgetful when, in reality, they have trouble hearing information and therefore, have more issues understanding and communicating effectively with others.

Dr. Sinha says dementia isn’t just memory loss but can also include changes to a person’s ability to understand spatial relationships, such as recognizing faces or objects in plain sight. These changes can affect driving, cause people to get lost on a regular walking route, or preparing a meal.

“When we talk about cognitive impairment or dementia, people think about memory, but it’s just one of the many cognitive domains we have,” he explains.

Dementia can also trigger mood issues. For instance, someone who loses their memory might start to withdraw from activities they typically enjoy, such as reading or playing board games. Dr. Sinha says some people may become depressed due to their memory or thinking problems, or it could be the other way around; a case of depression can cause a person to display memory or thinking problems that may resemble an early case of dementia.

“Try to get to the bottom of it,” he recommends for people who worry they or a loved one might have dementia. ”Then you can figure out things like: Are they depressed because they’re cognitively impaired, or vice versa.”

Dr. Sinha says people need to think about the different factors that may be contributing to memory loss before assuming it’s dementia.

“‘Senior’s moments’ are okay—and they do happen. It’s when you realize it’s worse than that [that people should have it checked out],” he says.

What are the early signs of dementia?

Examples of early dementia may include forgetting names of familiar people, missing appointments, forgetting to pay bills or take medications.

“Think about the person at their baseline,” Dr. Sinha says. “What could they always do that they’re no longer able to do and is it related to memory, thinking problems or something else? If you think it might be due to their memory or thinking, check it out to see if there’s something going on there—and what can be done.”

Once dementia is diagnosed, there are many steps people and their caregivers can take to help support them, says Audrey Miller, managing director of Elder Caring Inc. and a recognized expert in life care planning, aging and caregiving issues.

Supporting people with dementia

The first is getting emotionally prepared for dealing with dementia. ”It’s hard for people and their loved ones to recognize ‘something’s not right,’” Miller says.

From there, it’s about ensuring their environment is safe and functional. For instance, Miller says many households will put notes in well-used areas like the kitchen and bathroom to help jog the memories of people with dementia to complete their normal daily activities, such as making coffee or brushing their teeth. Some families bring in an occupational therapist to ensure there are no tripping hazards or other unsafe spaces in the home.

“For me, safety is number one,” Miller says.

For dementia sufferers who are at risk of wandering off, she says some families will install technology, such as alert systems that go off when the front door opens. “It’s about getting involved and taking preventative steps before the person has walked out the door.”

Miller says there are numerous resources available for people living with dementia. It’s also important to understand that the disease can affect people differently.

“It’s not a one-size-fits-all disease,” she says. “What’s needed is more awareness, so people don’t have to be afraid. It’s a scary disease; there’s no question, but there are people and resources here to help.”

Dementia prevention

While dementia mainly affects older people, experts insist it’s not a normal part of aging. Research shows about 40 percent of dementia cases can be delayed or prevented through lifestyle changes such as a healthy diet, regular exercise and maintaining a normal blood pressure.

“There are things we can do to keep our brains healthy,” Dr. Sinha explains.

He also recommends maintaining a healthy diet and getting regular exercise and addressing hearing loss issues early. Dr. Sinha also suggests other preventative measures, such as reviewing medications annually to ensure they don’t contribute to memory loss. For instance, some over-the-counter sleep medications can increase the risk of dementia, says Dr. Sinha.

“When people realize there are things we can do that can keep our brains healthy—and that dementia isn’t necessarily an inevitable part of aging—I think that gives a lot of people hope,” he adds.

“It also helps empower older Canadians to be proactive in keeping their brains active, so they can live healthy and independent for as long as possible.”

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